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States seeking to integrate Medicare and Medicaid services for dually eligible beneficiaries need to consider a variety of issues in program design and implementation such as incorporating behavioral health and long-term services and supports, consumers and providers engagement, and linking Medicare and Medicaid data. Use the filter below to view resources related to these and other topics.

Displaying 1 - 11 of 11

Other Resource | July 2019
States’ Medicaid Fee-for-Service Durable Medical Equipment Payment Policies
To better inform analysis of existing policies and development of future policies that affect Medicaid payments, the Medicaid and CHIP Payment and Access Commission (MACPAC) released a compendium of each state’s fee-forservice DME policies along… (Medicaid and CHIP Payment and Access Commission)
Other Resource | March 2019
Care Coordination in Integrated Care Programs Serving Dually Eligible Beneficiaries – Health Plan Standards, Challenges and Evolving Approaches
This MACPAC report reviews and analyzes care coordination requirements in the managed care organization contracts of nine states participating in demonstrations under the Financial Alignment Initiative, 10 states that contract with Fully Integrated… (Medicaid and CHIP Payment and Access Commission)
Technical Assistance Tool | January 2019
The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries
Dually eligible beneficiaries began enrolling in integrated Medicare-Medicaid plans (MMPs) under the Financial Alignment Initiative (FAI) in calendar year 2013. Under the FAI, the Centers for Medicare & Medicaid Services (CMS) and 10… (Mathematica)
Other Resource | March 2016
Report to Congress on Medicaid and CHIP - Chapter 4: Integration of Behavioral and Physical Health Services in Medicaid
This chapter discusses the approaches used by the Financial Alignment Initiative demonstrations, Medicare Advantage Dual Eligible Special Needs Plans, and the Program of All-inclusive Care for the Elderly to integrate behavioral health and physical… (Medicaid and CHIP Payment and Access Commission)
March 2016
Medicaid Managed Long-Term Services and Supports: Themes from Site Visits to Five States
During site visits to five states (Arizona, Florida, Illinois, New York, and Wisconsin), researchers identified major themes related to the rapid growth of Medicaid managed long-term services and supports (MLTSS) programs and the diversity of ways… (Mathematica)
Brief | September 2015
Financial Alignment Initiative for Beneficiaries Dually Eligible for Medicaid and Medicare
This brief describes the design of the Financial Alignment Initiative and compares key provisions of the 10 capitated model demonstrations. Separate fact sheets are available on each of the 10 demonstrations. (Medicaid and CHIP Payment and Access Commission)
Other Resource | May 2015
Experiences with Financial Alignment Initiative Demonstration Projects in Three States: Feedback from Enrollees in California, Massachusetts, and Ohio
This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations. (Medicaid and CHIP Payment and Access Commission)
Brief | December 2014
Measuring Up: A Novel Approach to Assessing State Oversight of Medicaid Managed Care
This brief assesses Washington State's oversight of Medicaid managed care plan performance under the state's 1915 (b) waiver by quantifying monitoring practices and comparing them to benchmarks inside and outside of Washington State. (Mathematica)
November 2013
Encounter Data Toolkit
This toolkit provides a practical guide to collecting, validating, and reporting Medicaid managed care encounter data and is designed as a guide for state Medicaid staff responsible for managing the daily operations involved in encounter data, as… (Mathematica)
March 2013
Issues in Setting Medicaid Capitation Rates for Integrated Care Plans
Chapter 5 of this report to Congress examines rate setting in capitated integrated care programs including PACE. (Medicaid and CHIP Payment and Access Commission)
Other Resource | February 2013
Toward a More Perfect Union: Creating Synergy Between the Money Follows the Person and Managed Long-Term Services and Supports Programs
This report examines how five states have structured the interface between MFP demonstration grants and Managed long-term services and supports (MLTSS) programs to promote transitions from institutional care to home- and community-based settings. (Mathematica)